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The relationship between management practices and the efficiency and quality of voluntary medical male circumcision services in four African countries.
Salas-Ortiz, Andrea; La Hera-Fuentes, Gina; Nance, Nerissa; Sosa-Rubí, Sandra G; Bautista-Arredondo, Sergio.
Afiliación
  • Salas-Ortiz A; Division of Health Economics and Health Systems Innovations, National Institute of Public Health (INSP), Cuernavaca, Mexico.
  • La Hera-Fuentes G; University of York, York, United Kingdom.
  • Nance N; Division of Health Economics and Health Systems Innovations, National Institute of Public Health (INSP), Cuernavaca, Mexico.
  • Sosa-Rubí SG; University of Newcastle, Newcastle, Australia.
  • Bautista-Arredondo S; Division of Health Economics and Health Systems Innovations, National Institute of Public Health (INSP), Cuernavaca, Mexico.
PLoS One ; 14(10): e0222180, 2019.
Article en En | MEDLINE | ID: mdl-31581192
INTRODUCTION: Given constrained funding for Human Immunodeficiency Virus (HIV) programs across Sub-Saharan Africa, delivering services efficiently is paramount. Voluntary medical male circumcision (VMMC) is a key intervention that can substantially reduce heterosexual transmission-the primary mode of transmission across the continent. There is limited research, however, on what factors may contribute to the efficient and high-quality execution of such programs. METHODS: We analyzed a multi-country, multi-stage random sample of 108 health facilities providing VMMC services in sub-Saharan Africa in 2012 and 2013. The survey collected information on inputs, outputs, process quality and management practices from facilities providing VMMC services. We analyzed the relationship between management practices, quality (measured through provider vignettes) and efficiency (estimated through data envelopment analysis) using Generalized Linear Models and Mixed-effects Models. Applying multivariate regression models, we assessed the relationship between management indices and efficiency and quality of VMMC services. RESULTS: Across countries, both efficiency and quality varied widely. After adjusting for type of facility, country and scale, performance-base funding was negatively correlated with efficiency -0.156 (p < 0.05). In our analysis, we did not find any significant relationships between quality and management practices. CONCLUSIONS: No significant relationship was found between process quality and management practices across 108 VMMC facilities. This study is the first to analyze the potential relationships between management and service quality and efficiency among a sample of VMMC health facilities in sub-Saharan Africa and can potentially inform policy-relevant hypotheses to later test through prospective experimental studies.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Circuncisión Masculina Tipo de estudio: Prognostic_studies Aspecto: Implementation_research Límite: Humans / Male País/Región como asunto: Africa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: México Pais de publicación: Estados Unidos
Texto completo
Añadir a Mi BVS
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Circuncisión Masculina Tipo de estudio: Prognostic_studies Aspecto: Implementation_research Límite: Humans / Male País/Región como asunto: Africa Idioma: En Revista: PLoS One Asunto de la revista: CIENCIA / MEDICINA Año: 2019 Tipo del documento: Article País de afiliación: México Pais de publicación: Estados Unidos